scholarly journals Expression of Carbonic Anhydrase-IX and Vascular Endothelial Growth Factor in Renal Cell Carcinoma and their Prognostic Significance

2021 ◽  
Author(s):  
Moumita Maiti ◽  
Ranu Sarkar ◽  
Aritra Bhattacharya ◽  
Prasenjit Sen Ray
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Prognostic Significance ◽  
P Value ◽  
Renal Neoplasm ◽  
Vascular Endothelial ◽  
Ca Ix ◽  
Low Malignant Potential ◽  
Clear Cell Rcc ◽  
Endothelial Growth Factor

Introduction: Renal Cell Carcinoma (RCC) is the most common adult renal malignancy. Histopathologically, clear cell RCC accounts for 65-70% of all RCCs. Carbonic Anhydrase-IX (CA-IX) is a transmembrane protein and takes a role in cancer development and progression. A 75-100% clear cell RCCs show CA-IX expression. But this varies with grade and stage of tumour. Vascular Endothelial Growth Factor (VEGF) is responsible for tumour angiogenesis and expressed variedly in RCCs. Both VEGF and CA-IX expression is mediated by Hypoxia Inducible Factor-1α (HIF-1α). Aim: The present study aimed to evaluate the expression of CA-IX and VEGF in respect to different grades and stages of RCC and assessing their prognostic significance. Materials and Methods: This was a cross-sectional, observational study done on 45 histopathogically diagnosed cases of RCC. It was performed in the Department of Pathology, Nil Ratan Sircar Medical College, Kolkata, West Banglore, India over a period of two years (February 2018 to January 2020). Expression of VEGF and CA-IX were studied by immunohistochemistry. Results were analysed in Statistical Package for Social Sciences (SPSS) software (version 16.0) using Pearson Chi-square test. A p-value of <0.05 was regarded as significant. Results: Out of 45 cases of RCC, 34 tumours (32 clear cell carcinoma and two multilocular cystic renal neoplasm of low malignant potential) were evaluated for CA-IX immuno expression. About 25 cases showed CA-IX positivity which inversely associated with grade and stage of RCC (p-value <0.05). The CA-IX had a diagnostic value in detecting clear cell RCC with sensitivity 73.53%, specificity 100% and accuracy 80%. With 28 (62.2%) cases of RCC showed VEGF positivity among which nine were VEGF 1+ and 19 cases VEGF 2+. The VEGF expression showed a positive association with the grade and Tumour-Node-Metastasis (TNM) stage of tumour (p-value <0.05). Finally, authors found a statistically significant inverse association between CA-IX and VEGF expression in RCCs with clear cell morphology including clear cell RCC and multilocular cystic renal neoplasm of low malignant potential (p-value=0.001). Conclusion: High grade RCCs show low expression of CA-IX and strong positivity with VEGF. Both these markers have a prognostic significance. From the therapeutic point of view, VEGF positive tumours, especially inoperable and metastatic cases, may be benefited by anti-VEGF therapy whereas CA-IX positive tumours respond well by treatment with Interleukin-2.

scholarly journals Two Cases of Sporadic Eosinophilic Solid and Cystic Renal Cell Carcinoma in Manitoba Population

2021 ◽  
pp. 106689692199322
Author(s):  
Seyed Mohammad Mohaghegh Poor ◽  
Shivani Mathur ◽  
Karl Kassier ◽  
Janetta Rossouw ◽  
Robert Wightman ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Preoperative Imaging ◽  
Renal Neoplasm ◽  
Renal Masses ◽  
Cystic Renal Cell Carcinoma ◽  
Eosinophilic Cytoplasm ◽  
Clear Cell Rcc

Two sporadic cases of eosinophilic solid and cystic renal cell carcinoma (ESC RCC), at our institution, are presented in this study to contribute to the growing literature on this novel renal neoplasm. The first patient was a 38-year-old female with two synchronous renal masses measuring 3.5 and 1.9 cm on preoperative imaging. The second patient was a 44-year-old female with an incidental renal mass measuring 4 cm. Both patients underwent uncomplicated radical nephrectomies. The 1.9 cm mass in the first patient was consistent with clear cell RCC. The dominant mass in the first patient and the tumor in the second patient had microscopic and macroscopic findings in keeping with ESC RCC including a tan appearance, abundant eosinophilic cytoplasm, and CK20+ and CK7− staining. Both patients had an uncomplicated course following surgery with no evidence of local recurrence or distant metastatic disease for 1 and 2 years for the first and second patient accordingly. These cases contribute to a growing body of literature regarding ESC RCC including, to our knowledge, the first reported case of synchronous ESC RCC and clear cell RCC. Further research about this novel renal neoplasm is needed.

Statin use and risk of renal cell carcinoma in three prospective cohort studies.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 679-679
Author(s):  
Kathryn M. Wilson ◽  
Alejandro Sanchez ◽  
Rebecca E. Graff ◽  
Sabina Signoretti ◽  
Toni K. Choueiri ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
P Value ◽  
Increased Risk ◽  
Clear Cell Rcc ◽  
Statin Use

679 Background: Evidence on statin use and incidence of renal cell carcinoma (RCC) is mixed. Previous results from the Nurses’ Health Study (NHS) and Health Professionals Follow-up Study (HPFS) found a suggestive protective effect in women but not in men (Liu et al, Cancer 2012). We conducted an updated analysis of statin use and risk of total and fatal RCC in the NHS, HPFS, and NHS 2 cohorts, with more than twice as many cases. Methods: We examined the associations between statin use and risk of RCC from 1990 to 2016 in HPFS (men), 1994 to 2016 in NHS (women), and 1999 to 2015 in NHS 2 (women). Information on statin use was collected every two years. We used Cox proportional hazards models, adjusting for known and suspected risk factors, to estimate hazard ratios (HR) and 95% confidence intervals (CI) for use of statins and risk of total and fatal RCC, RCC by stage at diagnosis, and clear cell RCC. We pooled results across cohorts using a random effects model. Results: We documented 661 cases of RCC (310 in HPFS, 255 in NHS, 96 in NHS 2), of which 132 (20%) were fatal. Of the 661 cases, 458 (69%) were clear cell. The pooled multivariable HR for total RCC was 1.01 (95% CI 0.84-1.21) for current statin use, updated over time. Current use was not associated with risk of fatal, advanced (stage T3 or higher), or localized (stage T1 or T2) disease. There were no associations between duration of statin use and risk of RCC; compared to never users, those with less than four years of total use had an HR of 0.91 (95% CI 0.71-1.18), and those with four or more years of use had an HR of 1.03 (95% CI 0.84-1.27). Among men, statin use was associated with increased risk of clear cell RCC (HR for current use: 1.48, 95% CI 1.04-2.11; HR for 4 or more years of use: 1.58, 95% CI 1.05-2.36). Statins were not associated with risk of clear cell RCC in women (HR for current use: 0.77, 95% CI 0.58-1.03; p-value for heterogeneity across cohorts = 0.02). Conclusions: Overall, statin use was not associated with risk of RCC in three large, prospective cohorts of US women and men. Statin use was associated with increased risk of clear cell RCC among men.

scholarly journals Case: Secondary polycythemia due to pazopanib in patients with metastatic renal cell carcinoma

2017 ◽  
Vol 11 (11) ◽  
pp. E449-50 ◽  
Author(s):  
Nedal Bukhari ◽  
Eric Winquist
Keyword(s):  
Renal Cell Carcinoma ◽  
Growth Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Growth Factor Receptor ◽  
Cell Receptor ◽  
Renal Neoplasm ◽  
Vascular Endothelial ◽  
Cell Renal Cell Carcinoma ◽  
Endothelial Growth Factor

Clear-cell renal cell carcinoma (RCC) is the most common primary malignant renal neoplasm. Up to 30% of patients have metastatic disease at the time of initial diagnosis.1 Small molecule inhibitors of vascular endothelial growth factor receptor tyrosine kinase (VEGFR TKIs) are used as first-line treatment for most patients with incurable RCC. Pazopanib is a TKI inhibiting VEGFR,1-3 as well as plateletderived growth factor receptors (PDGFRs) α and β and stem cell receptor c-kit. The most common side effects of pazopanib are diarrhea, hypertension, changes in hair colour, anorexia, nausea, and vomiting. Severe hepatic toxicity is the adverse effect of greatest concern,but is uncommon. Myelosuppressive effects are also noted, such as anemia, thrombocytopenia, and leukopenia, and are presumably mediated through c-kit inhibition. Erythrocytosis is a wellrecognized paraneoplastic syndrome associated with RCC; however, erythrocytosis due to pazopanib therapy has only recently been described. We report two cases and review of the literature related to this phenomenon.

scholarly journals Multilocular cystic renal neoplasm of low malignant potential: Mimicker of cystic clear cell carcinoma – urologist’s perspective

2020 ◽  
pp. 22-26
Author(s):  
Harish Challa ◽  
Hariharasudhan Sekar ◽  
Sandhya Sundaram ◽  
Sriram Krishnamoorthy ◽  
Natarajan Kumaresan
Keyword(s):  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Clear Cell ◽  
Malignant Potential ◽  
Renal Neoplasm ◽  
Lower Pole ◽  
Imaging Studies ◽  
Histological Criteria ◽  
Low Malignant Potential

Introduction Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) is a rare subtype of clear cell renal cell carcinoma (ccRCC) accounting for 2-4% of RCC. It is defined as a neoplasm that is composed entirely of numerous cysts surrounded by fibrous capsule and septa containing clear cells without expansile growth or mural nodules (WHO 2016). The purpose of this manuscript is to highlight that it is imperative to identify this entity by strict histological criteria and distinguish this entity from cystic ccRCC due to its low malignant potential, excellent prognosis with no recurrence or metastasis. Case report A 46-year-old male presented with continuous mild loin pain for a month. There were no lower tract urinary symptoms. Ultrasound abdomen showed left lower pole renal mass. CECT-KUB was done as a definitive investigation which showed a solitary left lower pole renal cystic lesion with enhancement of size 3.8x3.6cm (Bosniak IV). As per CT findings, the patient underwent Laparoscopic partial nephrectomy. Histopathological examination showed multiple cysts with thin septal walls possessing clear cells with low-grade nuclei. 2 years of follow-up postoperatively with imaging studies revealed no recurrence or metastasis. Conclusions The purpose of this report is to emphasize the need to identify this entity by strict histological criteria as per WHO guidelines, as imaging studies were more often inconclusive. Urologists should have an adequate understanding such an entity. Almost all cases are amenable to partial nephrectomy irrespective of size and no documented evidence of recurrence and metastasis which mandates less stringent follow up postoperatively as compared to ccRCC.

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